PDF(Pubmed)
Abstract：
BACKGROUND: The extensor indicis proprius (EIP) tendon is a frequently used donor for a variety of tendon transfers, most commonly for reconstruction of the extensor pollicis longus (EPL). EIP is known to have frequent anatomic variants including split tendons and variations in tendon arrangement.
OBJECTIVE: To characterize the anatomy of the EIP at the level of the extensor retinaculum, where tendon harvest is often performed, and share our preferred technique for EIP to EPL transfer.
METHODS: Twenty-nine fresh-frozen cadaveric forearms without history of forearm or hand injury or surgery were dissected. Tendon circumference and relationship of the EIP and extensor digitorum communis to the index (EDCI) at the metacarpophalangeal (MCP) joint and the distal extensor retinaculum were recorded. Distance from the distal extensor retinaculum to the EIP myotendinous junction was measured.
RESULTS: EIP was ulnar to the EDCI in 96.5% of specimens (28/29) at the distal edge of the extensor retinaculum. In the remaining specimen, EIP was volar to EDCI. Tendon circumference at the distal extensor retinaculum averaged (9.3 mm ± 1.7 mm) for EDCI and 11.1 mm (± 2.7 mm) for EIP (P = 0.0010). The tendon circumference at the index MCP joint averaged 11.0 mm (± 1.7 mm) for EDCI and 10.6 mm (± 2.1 mm) for EIP (P = 0.33). EIP had a greater circumference in 76% (22/29) of specimens at the distal extensor retinaculum whereas EIP had a greater circumference in only 31% (9/29) of specimens at the MCP joint.
CONCLUSIONS: The EIP tendon is frequently ulnar to and greater in circumference than the EDCI at the distal extensor retinaculum, which can be taken into consideration for tendon transfers involving EIP.
OBJECTIVE: To characterize the anatomy of the EIP at the level of the extensor retinaculum, where tendon harvest is often performed, and share our preferred technique for EIP to EPL transfer.
METHODS: Twenty-nine fresh-frozen cadaveric forearms without history of forearm or hand injury or surgery were dissected. Tendon circumference and relationship of the EIP and extensor digitorum communis to the index (EDCI) at the metacarpophalangeal (MCP) joint and the distal extensor retinaculum were recorded. Distance from the distal extensor retinaculum to the EIP myotendinous junction was measured.
RESULTS: EIP was ulnar to the EDCI in 96.5% of specimens (28/29) at the distal edge of the extensor retinaculum. In the remaining specimen, EIP was volar to EDCI. Tendon circumference at the distal extensor retinaculum averaged (9.3 mm ± 1.7 mm) for EDCI and 11.1 mm (± 2.7 mm) for EIP (P = 0.0010). The tendon circumference at the index MCP joint averaged 11.0 mm (± 1.7 mm) for EDCI and 10.6 mm (± 2.1 mm) for EIP (P = 0.33). EIP had a greater circumference in 76% (22/29) of specimens at the distal extensor retinaculum whereas EIP had a greater circumference in only 31% (9/29) of specimens at the MCP joint.
CONCLUSIONS: The EIP tendon is frequently ulnar to and greater in circumference than the EDCI at the distal extensor retinaculum, which can be taken into consideration for tendon transfers involving EIP.
摘要：
背景：指伸肌（EIP）肌腱是各种肌腱转移的常用供体，最常见的是重建长伸肌（EPL）。已知EIP具有频繁的解剖变异，包括肌腱分裂和肌腱排列变化。
目的：为了表征伸肌支持带水平的EIP的解剖结构，经常进行肌腱收获的地方，并分享我们首选的EIP到EPL转移技术。
方法：解剖了29例没有前臂或手部损伤或手术史的新鲜冷冻尸体前臂。记录了肌腱周长以及EIP和指伸肌与掌指关节（MCP）和远端伸肌支持带的指数（EDCI）的关系。测量从远端伸肌支持带到EIP肌腱连接的距离。
结果：在伸肌支持带远端边缘的96.5％的标本（28/29）中，EIP对EDCI是尺骨。在剩下的标本中，EIP是EDCI的手掌。EDCI远端伸肌支持带的肌腱周长平均为（9.3mm±1.7mm），EIP为11.1mm（±2.7mm）（P=0.0010）。对于EDCI，索引MCP关节处的肌腱周长平均为11.0mm（±1.7mm），对于EIP，平均为10.6mm（±2.1mm）（P=0.33）。EIP在远端伸肌支持带的标本中有76％（22/29）的周长更大，而EIP在MCP关节的标本中仅有31％（9/29）的周长更大。
结论：在远端伸肌支持带，EIP肌腱通常是尺骨，并且在周长上大于EDCI，可以考虑涉及EIP的肌腱转移。
目的：为了表征伸肌支持带水平的EIP的解剖结构，经常进行肌腱收获的地方，并分享我们首选的EIP到EPL转移技术。
方法：解剖了29例没有前臂或手部损伤或手术史的新鲜冷冻尸体前臂。记录了肌腱周长以及EIP和指伸肌与掌指关节（MCP）和远端伸肌支持带的指数（EDCI）的关系。测量从远端伸肌支持带到EIP肌腱连接的距离。
结果：在伸肌支持带远端边缘的96.5％的标本（28/29）中，EIP对EDCI是尺骨。在剩下的标本中，EIP是EDCI的手掌。EDCI远端伸肌支持带的肌腱周长平均为（9.3mm±1.7mm），EIP为11.1mm（±2.7mm）（P=0.0010）。对于EDCI，索引MCP关节处的肌腱周长平均为11.0mm（±1.7mm），对于EIP，平均为10.6mm（±2.1mm）（P=0.33）。EIP在远端伸肌支持带的标本中有76％（22/29）的周长更大，而EIP在MCP关节的标本中仅有31％（9/29）的周长更大。
结论：在远端伸肌支持带，EIP肌腱通常是尺骨，并且在周长上大于EDCI，可以考虑涉及EIP的肌腱转移。
